Bégin R, Massé S, Cantin A, Bisson G, Bergeron D
Department of Pneumology, Centre Hospitalier Universitaire, Sherbrooke, Quebec, Canada.
J Thorac Imaging. 1988 Oct;3(4):37-50. doi: 10.1097/00005382-198810000-00007.
The initial early reaction of pulmonary tissue to inorganic dust inhalation is a fibrosing macrophagic alveolitis. This initial pulmonary lesion can be detected by an enhanced gallium 67 pulmonary uptake and analyses of bronchoalveolar lavage. These two techniques can document not only the increased proliferation of macrophages, but also the activation of macrophages to produce excessive amounts of fibronectin and other factors of fibroblastic growth implicated in the pathogenesis of the pneumoconioses. Of equal clinical interest is the development of computed tomography, which has permitted better characterization of the early stages of fibrosis in the pneumoconioses. These refinements in disease recognition will contribute to the earlier detection of pneumoconioses before they become incapacitating. Newer therapeutic methods are also under investigation that could permit inactivation of either the dust itself or the pulmonary macrophage. The coupling of these new diagnostic and therapeutic developments will bring in a new era in occupational pulmonary medicine.
肺组织对吸入无机粉尘的最初早期反应是纤维化巨噬细胞性肺泡炎。这种初始肺部病变可通过镓67肺摄取增强和支气管肺泡灌洗分析来检测。这两种技术不仅可以记录巨噬细胞增殖的增加，还可以记录巨噬细胞的激活，以产生过量的纤连蛋白和其他与尘肺病发病机制有关的成纤维细胞生长因子。同样具有临床意义的是计算机断层扫描的发展，它能够更好地描述尘肺病纤维化早期阶段的特征。这些疾病识别方面的改进将有助于在尘肺病导致失能之前更早地检测到它们。新的治疗方法也在研究中，这些方法可能使粉尘本身或肺巨噬细胞失活。这些新的诊断和治疗进展的结合将开创职业性肺病医学的新纪元。
